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Does Women With Hashimoto's Disease Have Trouble Being Pregnant?

Posted on Sat, 22 Mar 2014

Question: Hello Sir, My name is XXXXX; I love a girl which has Hashimoto's disease. My parents are worried about her hypothyroidism and its consequences during pregnancy. My parents are against this marriage. They are thinking that the girl cannot get pregnant. If any chance, she could, there may be chances of fetus deformities. I want to marry her and I need your opinion.

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer: Thyroid Detailed Answer: There is some truth to your parents' concerns, however in this day and age thyroid problems are easily managed with good medical care by super specialist thyroid doctors such as endocrinologists. Conceiving is a problem only if the thyroid is severely untreated or under treated. Even then there are reports of women getting pregnant despite grossly high TSHs. The other issue is often fetal deformities. There are some reports of such problems, again with very poorly managed or undiagnosed hypothyroidism. Further there could be other problems in the child from inadequately treated hypothyroidism. The best way to prevent all these issues is to be in close care of an Endocrinologist who will guide properly regarding correct levothyroxine dose. From the current labs that you gave shared, she seems to be getting a dose higher than necessary for her body. I see you are in Bangalore. There are plenty of well qualified MD DM Endocrinologists there.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

Thank you so much Doctor. This is very valuable information for me. I feel relaxed and thinking to go ahead with my relationship. I learnt that Female with hypothyroidism struggles for weight reduction but she has reduced almost 6 Kg within a couple of months. I think this is a positive sign. Currently, she is consulting with Dietician and Endocrinologist. Also, she is doing rigorous physical exercise. Is this a right way to reduce the weight? Would you like to suggest any super specialist thyroid doctor from Bangalore? I have already taken an appointment of Dr. C.B. XXXXXXX

Answered by Dr. Shehzad Topiwala (37 minutes later)

Brief Answer: Follow up Detailed Answer: She is heading in the right direction except her TSH is off so a dose adjustment might well be necessary. She must ideally be under the care of an MD DM Endocrinologist only, for life.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (19 hours later)

Hi Doctor. Thanks for your affirmative answers, further giving me confidence she is heading in the right direction.I had few more questions. 1) What are signs which we should look at, which give confirmation that her thyroid is under control and we can be at peace.In my vision, I can think of two signs. Can u further elabroate. a) regular menstrual cycles b) weight reduction on exercise. 2) If after exercising she reaches on her optimum weight after a year. In future she would require to be on thyronorm(levothyroxine) continuosly(dose adjustment as per requirement). If she is on medication regularly would then also she gain weight if she stops exercising? Hi doctor, Regarding her TSH being too low. She was earlier on 125mcg on all days of the week. But when the TSH went low, the doctor asked her to take 125mcg of thyronorm from Monday to friday. And on Saturday and Sunday she is on 50mcg. The doctor then asked her come after 3 months in April 2014 with the TSH fresh lab results. What are your thoughts on this. Does she require a more lower dose? Further more if we plan a pregnancy what care should be taken before concieving and even after conception. Thanks, XXXXX

Answered by Dr. Shehzad Topiwala (22 hours later)

Brief Answer: Second follow up Detailed Answer: The dose adjustments mentioned above are reasonable, as long as follow up testing is done regularly Thyroxine is required for life provided the diagnosis is correct. This can be ascertained only by seeing an endocrinologist who performs a comprehensive evaluation. Before getting it is ideal to have thyroid in normal range ie TSH between 0.4 to 2.5 with free T4 in the mid to high end of normal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (33 minutes later)

Hiee Doctor. Thanks for your affirmative answers, further giving me confidence she is heading in the right direction.I had few more questions.I had asked these questions before,but may be you misssed out on them 1) What are signs which we should look at, which give confirmation that her thyroid is under control and we can be at peace.In my vision, I can think of two signs. Can u further elabroate. a) regular menstrual cycles b) weight reduction on exercise. 2) If after exercising she reaches on her optimum weight after a year. In future she would require to be on thyronorm(levothyroxine) continuosly(dose adjustment as per requirement). If she is on medication regularly would then also she gain weight if she stops exercising?

Answered by Dr. Shehzad Topiwala (48 hours later)

Brief Answer: Third follow up Detailed Answer: 1 It is extremely difficult to go by symptoms because they are vague and non specific such as weight gain and fatigue. The best way is to regularly undergo blood test for TSH and free T4 every 3 to 6 months based on your endocrinologists' recommendation 2 When she is on a stable, steady and appropriate dose for her body, she is then like a normal person who does not have a thyroid problem. So all matters pertaining to weight, lifestyle and exercise are same for her as for an person. There is no point analyzing the thyroid in this equation

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar